11 things for a woman to keep in mind on World Aids Day

Women and girl children are disproportionately affected by HIV and AIDS. The pointers below are from AVERT’s ‘Women, HIV and AIDS’ report.

1. Globally, HIV/AIDS is the leading cause of death among women of reproductive age; although the percentage of women living with HIV and AIDS varies significantly between different regions of the world.

2. In areas with few palliative care facilities, when a person becomes ill from AIDS the care is usually a woman’s responsibility. In Africa for example, two-thirds of all caregivers for persons living with HIV and AIDS are women.

3. The AIDS epidemic also affects young girls and elderly women. Often in households where both parents are ill from AIDS, the responsibility of main carer is taken on by a daughter, even if it means that she has to miss school.

4. In some societies, women have few rights within sexual relationships and the family. This power imbalance means that it can be more difficult for women to protect themselves from getting infected with HIV

5. Women who are victims of sexual violence are at a higher risk of being exposed to HIV, and the lack of condom use and forced nature of rape means that women are immediately more vulnerable to HIV infection. A South African study concluded that women who were beaten or dominated by their partners were much more likely to become infected with HIV than women who were not. Another study of 20,425 couples in India found not only that HIV transmission was much greater in abusive relationships, but also that abusive husbands were more likely to be infected with HIV than non-abusive husbands.

6. In many countries women do not have the same property rights as men. Especially in sub-Saharan Africa, property is typically owned by men and even when married, women still do not have as many property rights as their husbands. Inheritance rights are just as discriminatory, as when a husband dies, his property often goes to his side of the family and not to his wife. The denial of a woman’s inheritance and property rights can increase her vulnerability to HIV. Not being able to own property means that women have limited economic stability. This can lead to an increased risk of sexual exploitation and violence, as women may have to endure abusive relationships or resort to informal sex work for economic survival.

7. Lesbians/bisexual women are not at high risk of contracting HIV through woman-to-woman sex. Very few women are known to have passed HIV on to other women sexually, though it is theoretically possible if infected vaginal fluids or blood from an HIV positive partner enter the other woman’s vagina (perhaps on fingers or sex toys).

However, like many women:

Some lesbians have unsafe sex with men – one British study found that 85 per cent of women who have sex with women reported also having sex with men.

Some lesbians inject drugs and share needles – research into injecting drug users has shown higher HIV prevalence among women who have sex with women, compared to heterosexual injecting drug users.

Some lesbians wanting to get pregnant face decisions about sperm donors – legitimate sperm banks screen donor’s semen for HIV and other STDs. However, many lesbians chose to use the sperm of someone they know, rather than using a sperm bank.

Preventing HIV infection

8. The female condom is the only female-initiated HIV prevention method presently available. These condoms can potentially help women to protect themselves from becoming infected with HIV if used correctly and consistently.

Post exposure prophylaxis is an antiretroviral drug treatment that is thought to decrease the chances of HIV infection after exposure to HIV. This treatment could potentially benefit women who have been raped, if started within 72 hours of exposure. In many countries with high levels of sexual violence against women and high HIV prevalence, this treatment is not always freely available to women.

Protecting and promoting women’s rights

9. In many parts of the world there exist major inequalities between women and men in all aspects of living – from employment opportunities and availability of education, to power inequalities within relationships. These gender roles can confine women to positions where they lack the power to protect themselves from HIV infection. As most of the inequalities that women face are denying them their basic human rights, promoting these rights will enhance their status within society and help protect them against the risk of HIV infection.

Transforming gender roles

10. Recognising and challenging harmful gender roles is crucial to preventing the spread of HIV. Gender-based expectations can increase vulnerability to HIV infection. For example, in many societies women are expected to be innocent and submissive when it comes to sex, preventing them from accessing sexual health information and services. For many men, masculinity is linked with taking risks and being tough, which can increase vulnerability to HIV infection and discourage men from seeking testing and treatment.

Increasing education and awareness

11. Education is one of the most effective tools in preventing HIV infections. An estimate from the Global Campaign for Education suggests that if every child received a complete primary education, around 700,000 new HIV infections in young adults could be prevented every year.Education is particularly important for protecting girls against HIV infection. Also, girls who frequently attend school are more likely to be able to make decisions about their sexual lives, are more independent, and are more likely to earn a higher income in the future.